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General NPI Number Information
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NPI Number | 1104338987
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Entity Type | Individual
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Provider Name | LIA MONTOYA OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/01/2017
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Last Update Date | 11/01/2017
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Provider Practice Location Address
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Address Line | 4510 VIEWRIDGE AVE
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City | SAN DIEGO
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State | CA
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Zip | 92123-1637
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Country | US
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Telephone | 818-719-4538
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Fax |
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Provider Business Mailing Address
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Address Line | 2281 ULRIC ST APT 1
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City | SAN DIEGO
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State | CA
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Zip | 92111-6445
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Country | US
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Telephone | 916-335-9444
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 18070
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License Number State | CA
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